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Your Emotions

You're holding your new baby in your arms. You may feel overjoyed, wishing to call everyone you know with your news! If you had an unexpected birth experience or procedure (such as a cesarean birth), you may feel disenchanted. Or, you may actually feel relieved that your baby is safe and well. You could possibly feel guilty because things didn't go as planned. Maybe you're just exhausted and ready for a good meal and a long nap. The full range of emotional experience is easily understood by other mothers who have experienced what you have. Talk to your partner, your doctor or nurse-midwife about how you're feeling. It is important to realize that you're not alone in this time, and that you're also not the first person to go through this draining experience.

Physical Pain after Birth

Pain after birth can have several causes. It may be caused by:

• Afterbirth contractions as your uterus begins returning to normal size. (This is commonly stronger and more uncomfortable for mothers who have had a baby before
• Hemorrhoids, which are common after birth and cause itching and burning sensations
• Episiotomy incision
• Muscle aches and/or back pain

The pain you feel as your body recovers from childbirth is natural, so it's helpful to remember that the miraculous process that brought a sweet little life into your arms is still ongoing. Most likely, you will feel motivated to move beyond the discomfort to enjoy caring for your baby.

We don't recommend suffering through your postpartum period in unnecessary pain, however. Managing pain through medication can be controlled with little or no risk to you or baby. It can render you more active, improve your eating and sleeping, and leave you feeling more positive.

Because some pain medications can be addicting, never stray from the specific type and dosage prescribed by your doctor or nurse-midwife. It's impossible for nurses to measure the pain you're having, so it's up to you to tell them how you feel. If you have questions about controlling your pain when you get home, or if the pain medicine isn't working, talk to your healthcare provider.

Along with advising you about pain medicine choices, your doctor or nurse-midwife can suggest additional comfort measures. Cold-packs or ice-packs on the episiotomy incision can provide relief, as can heating pads, massage and relaxation.

Important Note: If you ever have difficulty communicating your concerns to the nurse assigned to you, you may ask to speak to the charge nurse.

Pain after Cesarean Birth

Recovering from surgery takes longer than recovering from a vaginal birth, and it's also more uncomfortable. Managing your pain properly can actually help you get well faster. Even if you are breastfeeding, take the pain medicines offered so that you can walk, move, feed and care for your baby in comfort. The most discomfort occurs at the very beginning, so keep a positive attitude because it's going to get easier!

It's normal to have stiffness, soreness, a dry throat, pain in the incision, uterine cramping, and abdominal gas pains. It may be helpful to place a hand or a pillow over your incision when you move, walk, laugh or cough.

Painful Gas

Gas pains after surgery are common, and sometimes peak 2-3 days after surgery. If you can provide gentle movement and pressure on your abdomen, the pain of gas cramps will be reduced.

You may also try the following:

• rocking in a rocking chair
• drinking hot lemon water
• walking

Caring for Your Baby in the Hospital

It is important for you to know that all of your baby's care can be provided right there in your room, so keep your baby there with you as much as possible. This is a good time for you to learn your baby's cues for feeding & comfort, and you'll have the help of experienced nurses. Work with your partner, nurse, and family members to handle times when you are in the shower or napping. Hospital and Birth Centers typically provide diapers, clothing and extra baby supplies if you need them.

Important Note: It is always OK to ask questions. Do not worry about bothering the nurses or hospital staff. You may have questions or concerns about baby care or postpartum care, and they are paid to answer them!

Your Baby's Security

Typically, your baby's identification and your name are printed on bracelets, and placed your baby's ankle or wrist. You and your partner get the same thing! Each time your baby is brought to you, this identification bracelet will be checked and compared with your own. We encourage you to check with your hospital about their security procedures.

Going Home

Your doctor and/or nurses will typically make sure the following before you and baby leave the hospital:

• you have no fever or excessive bleeding
• your stitches (if you have any) are beginning to heal
• you can walk around and urinate by yourself
• you know how to take care of baby and yourself
• your pain is being managed properly (using the methods prescribed by your doctor or nurses)
• baby has had at least two successful feedings or a follow-up plan is in place
• baby has made both wet and dirty diapers

When you are ready to go home, state law requires that all infants travel in an approved car seat. Be sure to position the car seat in the back-seat of the car for your baby's first ride home.

Here are some additional questions you may wish to ask before leaving the hospital:

• What should my activity level be at home?
• Are there any activities that should be restricted?
• What symptoms should I watch for?
• Are there any special feeding instructions?
• If I think my baby is sick, who do I call?
• How long should I be calling you with medical questions, and when should I switch back to my primary health care provider?
• When can I return to work?
• When can I drive?

Recovering at Home

It will take some time for you and your baby to recover from the labor and delivery experience. It will also take time for you and your partner to transition smoothly into this new era in your life together. Remember to be patient, compassionate and kind to each other. Like everything in life, we have to work at things a little before they feel entirely comfortable.

Normal Vaginal Bleeding

Bleeding from the vagina (as if during a menstrual period) is normal after childbirth, regardless of how you delivered. This is caused by the gradual healing inside your uterus (where the placenta was once attached), and gradual tightening of the uterine muscles as they return to normal size. This period can sometimes last several weeks.

During the first few days, the blood will be bright red and heavier than a normal period, and it may contain small blood clots (smaller than a ping-pong ball). There may sometimes be a gush of blood when you initially get up out of bed and stand-up. The bleeding will gradually decrease over time, changing in color from red to pinkish, to brown, to white and finally clear by 4 to 6 weeks after birth. If you get too active too soon, the bleeding may become bright red again. Your body may be trying to tell you to slow down. Lie down and rest.

Important Note: Do not use tampons until after your 6-week post-birth exam with your health care provider. Use sanitary pads and change them often.

When to Call Your Health Care Provider

Whether your baby was born by cesarean or vaginal birth, call your health care provider if you have any of these symptoms:

• Bright red bleeding that soaks through a pad in 1 hour (or less), especially if it contains clots of whitish tissue
• Blood clots that are as big as (or larger than) a ping-pong ball
• Bad-smelling or greenish vaginal discharge
• Fever or chills with a temperature of 100.4 degrees Fahrenheit or higher
• Any hard, red, painful area in your breast, along with a fever or chills
• Difficulty breathing
• Abdomen that is tender to the touch (other than usual tenderness around a cesarean incision)
• Abdominal incision that is red, warm to the touch, or has drainage
• Pain or burning when passing urine, a change in how often you pass urine, or not being able to empty your bladder
• Stitches that have become painful, red or separated, or have pus-like discharge (with or without a fever)
• Headache or double/blurred vision
• Constant back, abdominal, or pelvic pain
• Deep pain, redness, warmth, or swelling in any area of either your leg, or pain when you point your toes toward your nose
• A feeling of sadness or depression that lasts longer than a week
• Lack of energy to care for yourself or baby

Tips for Recovering at Home

• When your baby is asleep, try to get some rest
• Limit the number of visitors
• Let your family and friends help you
• Take an infant massage class
• Take a mother-baby fitness class
• Attend a parenting class
• Attend an infant and child CPR class

Newborn Care at Home

Many folks are unaware that newborns on TV and in the movies are played by 3-month-old babies. Newborns typically arrive covered with vernix (a white, cheesy coating); with small, flattened nose and head that's shaped funny.

This is natural, and temporary, just like these additional newborn characteristics:

• Puffiness around the eyes and/or facial bruising
• Fine, fuzzy hair on the back, shoulders, ear and cheeks (known as "lanugo")
• Breast enlargement (in both boys and girls), and sometimes swelling of the genitals
• Pinkish vaginal discharge in baby girls (this is due the hormones you passed-on, and it disappears by itself)

Some Natural Baby Behaviors

• Sneezing
• Hiccups after eating (or too much stimulation)
• Noisy Breathing (not a concern unless skin begins to turn blue)
• Crossing the eyes (until about 4 months of age)
• Jerking movements of the arms and legs (a response to newfound freedom)
• Gagging, burping and passing gas

Is Baby Hungry?

Watch for the following early feeding cues or signs such as:

• Open mouth with make little sucking movements
• Putting a fist to in the mouth
• Turning toward anything that comes near her mouth or cheeks
• Squirming movements
• Making soft sounds
• Eyes moving quickly beneath her eyelids. This is Rapid Eye Movement (REM)

When your baby shares these feeding cues, put her to your breast or prepare a bottle for her.